Seven out of 10 unmarried boys own a mobile phone. Around half of ever-married females and a quarter of unmarried girls own a cell phone, it found.

At least half of the phones are smartphones. Almost half of unmarried males and one-fifth of married and unmarried female adolescents access the internet at least once a week.

According to the first national Adolescent Health and Wellbeing survey, most (76-85%) of Bangladeshi adolescents consume food having adequate dietary diversity.

“In Bangladesh, one in every four households has at least one adolescent (aged between 15-19 years). More than 97% of these adolescents have attended formal education institute at least once,” the data showed.

The report of the nationwide survey was launched on Thursday at a city hotel while Health and Family Welfare Minister Zahid Maleque attended the event as the chief guest.

The survey was conducted (in five phases between 25 July 2019 to 10 January 2020) with a nationally representative sample of 72,800 households, covering around 18,000 adolescents age 15-19 years.

The primary objective of the survey was to examine and understand the state of health and well-being of male and female adolescents.

The final report consists of 12 chapters ranging from an array of topics including exposure to media; marriage; menstrual hygiene; gender norms; violence; mental health; nutrition and dietary diversity; and social connectedness with family and friends.

Multi-sectoral approach needed

The survey also revealed that, 73% of unmarried female adolescents and 66% of unmarried male adolescents desired to know about puberty/physical changes. While adolescent girls rely on books for getting information, internet is the most availed medium of getting information for male adolescents. Nationally, majority of female adolescents had no prior knowledge about menstruation before it occurred for the first time.

Almost all (98%) of both ever married and unmarried adolescents reported using either disposable products or reusable materials cleaned with water and soap/detergent during menstruation.

However, the hygienic menstrual practices are very low among both ever married (9%) and unmarried (12%) adolescents. Most notably, one in four ever married and unmarried in-school adolescents missed at least one day of school during their last menstruation.

As per the survey, around one in every 10 unmarried adolescents are under weight and another one tenth are overweight.

Around 76-85% of adolescents consume adequate dietary diversity, which is more than four food groups out of five comprised of fruits and vegetables, starchy food, dairy, protein and fat. Most adolescents (70-78%) also consume iron- enriched food. But only around a quarter are consuming vitamin A rich food – the survey reveals.

Xerses Sidhwa, Director of Office of Population Health and Nutrition, at USAID/Bangladesh said, “We can see from the results that the adolescents want more information on reproductive health like menstruation, puberty, and physical changes. Now is the time for us to think how we can reach these adolescents in a more efficient way. For this we would need effective multi-sectoral approach.”

Upholding health sector progress

Minister Maleque said that adolescent health and wellbeing have always been a priority for Bangladesh government and its health ministry. Recognising the critical area of focus, the ministry formulated the National Strategy for Adolescent Health 2017-2030.

Despite making strides in different areas of health services, early marriage and teen-pregnancy rates are still high. It is imperative to prevent early marriage and provide meaningful sexual and reproductive health education and services starting from adolescence to uphold the progress we are making in the health sector, he said.

The survey revealed that, among ever-married adolescents, 97% are currently married, while 3% of adolescents aged 15-19 are separated, divorced, or widowed.

Seventeen percent of currently married girls have been married for four years or more. Regarding spousal age difference, 30% of female adolescents have an age difference of 10 or more years with their husband. The highest proportion of female adolescents with a spousal age difference of 10 years or more is among those in the highest wealth quintile (45%) – the survey finds.

Over one third (34%) of ever married females and one fifth (18%) of unmarried females perceived that the husband has the right to beat his wife when she does not listen to him. In case of sexual harassment, it is very shocking that 88% unmarried female adolescents experience sexual harassment while commuting on the road and 19% experience this at schools.

icddr,b monitored data collection with 18 independent field monitoring officers and four quality control teams that accompanied the data collection teams, observed household and individual interviews, and re-interviewed selected sections of individual and household questionnaires along with observations.

They also provided feedback as and when necessary and followed individual interview completion status through a mobile app.

The survey was led by the National Institute of Population Research and Training (NIPORT) with technical assistance from Research for Decision Makers (RDM) project of icddr,b and Data for Impact (D4I) of the University of North Carolina at Chapel Hill. The survey was funded by the Government of Bangladesh, USAID/Bangladesh and Foreign, Commonwealth and Development Office (FCDO) of the UK Government (formerly known as DFID).